Chronic Inflammation

Question 1

define chronic inflammation

Answer 1

prolonged inflammation with associated repair

delayed onset
variable duration
variable appearances 
limits damage initiates repair 
can cause debilitating repair

Question 2

how does chronic inflammation arise

Answer 2

1) takes over from acute
2) develops alongside acute
3) arises ‘de novo’

Question 3

why are marcophages in the lung sometimes black

Answer 3

they phagocytose carbon

Question 4

what causes the abundant foamy cytoplasm in macrophge

Answer 4

phagolysosomes

Question 5

macrophage function

Answer 5

phagocytosis

inflammatory mediators

• synthesis and release of many mediators
• controls and regulates inflammatory response

Question 6

plasma cell appearance

Answer 6

eccentric nucleus
clock face chromatin
peri nuclear clearing - golgi

Question 7

plasma cell function

Answer 7

fully differentiated B lymphocyte

produces antibodies

Question 8

eosinophil function

Answer 8

release a variety of mediators
hypersentitivity reactions
parasitic infections

Question 9

giant cells

Answer 9

multinucleate cells
fusion of multiple macrophages

‘frustrated phagocytosis’

Question 10

foreign body giant cell

Answer 10

random scattering of nuclei

Question 11

langerhans giant cell

Answer 11

arranged around the outside of the cell- Horseshoe shape

seen in tuberculosis

Question 12

touton giant cell

Answer 12

nuclei lined up in the middle
remaining cytoplasm of giant cell is pale and foamy

seen in fat necrosis

Question 13

what do proportions of cell types indicate

Answer 13

rheumatoid arthiritis - mainly plasma cells
chronic gastritis- mainly lymphocytes
leishmaniasis- mainly macrophages

Question 14

effects of chronic inflammation

Answer 14

fibrosis

• repair process
• deposition of collagen

impaired function
-rarely =increased function

atrophy

stimulation of immune response
-antigen presentation

Question 15

Crohn’s disease

Answer 15

can affect all of GI tract
(mouth to anus)

discontinuous patches of inflammation
‘skip lesions’

inflammation affects full thickness of bowel wall ‘transmural’ strictures/fistulae

can sometimes find granulomata

less likely to have rectal bleeding

Question 16

ulcerative colitis

Answer 16

affects large bowel only 
contiuous inflammation 
inflammation affects superficial bowel only- mucosa and submucosa 
no granulomata 
more likely to have rectal bleeding

Question 17

what is granulomatous inflammation

Answer 17

a specific type of chronic inflammation…
chronic inflammation and granuloma

multiple-granulomata

Question 18

granulomata

Answer 18

a collection of epitheliod histiocytes

macrophages that look like epithelial cells with surrounding lymphocytes

Question 19

foreign body granuloma

Answer 19

destruction and removal of foreign material

few lymphocytes

Question 20

immune mediated granuloma

Answer 20

destruction and removal of pathogens- bacteria and fungi

can undergo central necrosis

can be idiopathic

many lymphocytes

Question 21

causes of granulomatous inflammation

Answer 21

foreign body reaction

infections

Question 22

mycobacterium granuloma

Answer 22

epithelioid histocytes
lymphocytes
caseous necrosis

Question 23

causes of granulomatous inflammation

Answer 23

Crohn’s disease

sarcoidosis- no caseating granulomata in lymph nodes, lungs and skin

Question 24

when do you see Touton giant cell

Answer 24

xanthoma

fat necrosis